Via Teleconference 

11:04 A.M. EDT

MR. ZIENTS:  Good morning, everybody.  It’s Jeff Zients, and I’m joined by Dr. Walensky and Dr. Fauci.  Thanks for joining us.

Given the scheduling constraints to switch from yesterday to today, we shifted to phone briefing, so we will get back to our regular format next week.

You will be able to see slides on this screen as we progress here.

I’ll — I’m going to say a few minutes without slides, and then I’ll turn to Drs. Fauci and Walensky in a moment.

First, I want to start with a focus on the progress we are making on vaccinations, which we all know is the best line of defense against COVID-19 and the Delta variant.

Importantly, we just received today’s vaccine report.  The report is 1.1 million shots in arms.  1.1 million shots in arms is the highest single-day total since July 3rd — so, eight weeks ago.

And, so far, in August, we’ve gotten nearly 12.5 million first shots in arms, which is obviously important, and more people are getting their first shot and beginning their vaccination regimen.  That’s already 2 million more shots than in all of July.  The 12.5 million first shots in arms is 2 million more first shots than in all of July, with several days still left to go to add to that total in August.
Importantly, we have now hit a major milestone in our effort to vaccinate adolescents.  Fifty percent of 12- to 17-year-olds now have at least their first shot.  Fifty percent of adolescents — this is critical progress as millions of kids head back to school.  

And, in fact, the vaccination rate among adolescents is growing faster than any other age group.  And we will continue to do everything we can to get this group of adolescents vaccinated, because as Dr. Walensky and Dr. Fauci will discuss, these vaccines are safe and effective.  And a key way we can keep kids safe and in school is by getting more kids 12 and over vaccinated.

We continue to push for more progress on vaccinations across the board, including through vaccination requirements.

The President has adopted vaccination requirements for federal workers, the armed forces, the VA, and HHS healthcare personnel.  And also, nursing homes participating in the Medicare and Medicaid program will now be required to have their staffs vaccinated.

This week, the President reiterated his call for public and private sector leaders to follow his lead on vaccination mandates.  And we’re seeing continued momentum for stronger vaccination requirements across the country.

Just since Monday, more employers are stepping up, including Disney, Deloitte, and the City of Chicago.

The Business Roundtable, which represents more than 200 businesses that employ a total 20 million workers, endorsed COVID-19 vaccination requirements.  And they are encouraging state and local policymakers to, quote, “support — not impede — companies’ ability” to adopt these requirements.

And just this week, nearly 50 colleges and universities, including The Ohio State University — one of the largest in the country — announced students, faculty, and staff will need to be fully vaccinated.

And at Louisiana State University — LSU — to attend a football game this fall, you’ll need to be vaccinated or show proof of a negative test.

Overall, 800 colleges and universities, more than 200 healthcare employers, large and small businesses across the country, and many state and local governments have all adopted vaccination requirements to protect students, healthcare personnel, patients, employees, and consumers.

Together, these vaccination requirements add up to make a big difference — helping protect tens of millions of Americans at work, at school, in healthcare settings, and at sporting events. 

This is the power of Americans coming together — all of us doing our part to protect not just ourselves, but our families and friends, our neighbors and colleagues, our communities and our country.  We can’t and we won’t let up.  And we need everyone to get the job done.

So, if you’re an American who is not yet vaccinated, or if you’re an employer who has yet to adopt vaccination requirements, we have a very simple message: Get off the sidelines, step up, and do your part.  Individuals, get vaccinated.  Employers, adopt vaccination requirements.  You have the power to protect your communities and help end the pandemic.

With that, let me turn it over to Dr. Walensky.  Dr. Walensky.

DR. WALENSKY:  Thank you, Jeff.  Good morning, everyone.  We’ll begin with an overview of the data. 

Yesterday, CDC reported nearly 165,000 new cases of COVID-19.  Our seven-day average is at about 142,000 cases per day.  This represents an increase of nearly 3 percent from the prior seven-day average. 

The seven-day average of hospital admissions is about 12,000 per day, an increase of about 6 percent from the previous seven-day period. 

And the seven-day average of daily deaths has also increased to 864 per day, an increase of nearly 11 percent from the previous seven-day period. 

Today, I want to talk about children.  As a mother of three, I know how important it is for us to protect our kids and give them every opportunity to succeed.  And this is why it is so important for us to get our children safely back in the classroom for in-person learning.

While symptomatic and severe cases in children remain less common than in other age groups, we have seen increases in pediatric cases and hospitalizations over the last few weeks — which is likely the result of overall increases in community transmission generally, and more specifically, the Delta variant’s increased transmissibility.

It’s human nature to protect our children above all else.  And the best way to protect them is to get everyone who is eligible vaccinated and surround children who are not yet vaccine eligible with people who are vaccinated to effectively shield them from COVID harm. 

We also have clear scientifically-backed guidance that offers a framework for schools to open and remain open for a safe and healthy learning environment in this unprecedented academic year ahead. 

Evidence has repeatedly demonstrated that multi-layer prevention strategies, such as vaccination for all children and adults who are eligible; masks for all students, teachers, staff, and visitors; ventilation; cohorting; physical distancing; and screening testing work to prevent the spread of COVID in schools. 

Schools should implement as many of these prevention layers as possible simultaneously.  And this serves to protect our children, even if there are inevitable breaches in any single protection layer. 

Adding to this body of evidence, two studies will be published in today’s MMWR that demonstrate the importance of consistent and correct use of these mitigation strategies, especially vaccination and universal masking. 

In their first report looking at COVID cases in Los Angeles County, we saw the power of layered prevention.  School-associated cases remained lower than cases in the community because of prevention efforts.

In schools with safety protocols in place, case rates in children and adolescents were about three and a half times lower during the winter peak compared to rates in the community. 

Even when communities were experiencing high levels of COVID transmission, in the LA County study, layered prevention measures in schools provided a shield of pretension [sic], helped to keep COVID out of school, and reduced the spread when cases did occur.

In a separate report that closely studied an outbreak in a school in northern California, we saw the absence of optimal multi-layer prevention can result in spread of COVID in this classroom and beyond. 

The introduction of the virus into the classroom by a teacher who worked in school while she was both symptomatic and unvaccinated and who was unmasked when reading aloud to a class resulted in cases within the classroom, across the school, and among families of students and staff in the community.

We know how to protect our kids in school.  We have the tools. 

This week, CDC released toolkits to help schools plan for and implement screening testing and for parents to understand what they should be asking of, indeed expecting of their school systems to keep their children safe. 

Unfortunately, many schools have opted not to implement these recommended tools.  We recognize and are closely following cases and hospitalizations in children at the same time as school reopening.

In our outbreak investigations, large-scale quarantines or large number of cases are generally occurring in schools because schools are not following our guidance, particularly our recommendations for teacher, as well as students aged 12 and over, to be vaccinated and for everyone right now to be masked.

I want to strongly appeal to those districts who have not implemented prevention strategies and encourage them to do the right thing to protect the children under their care.  We know these multi-layered mitigation strategies work, and thanks to the American Rescue Plan, schools have the resources to implement these strategies.

Universal masks in schools work to prevent outbreaks and reduce the risk of children bringing the virus home to others who are vulnerable.  This is not forever; this is for now. 

Good ventilation reduces the number of virus particles in the air and helps prevent transmission.  This is not only true for COVID-19, but for all other respiratory viruses that will inevitably circulate throughout the school year. 

Vaccines work to prevent serious illness, hospitalization, and death.  And when our children who are not yet eligible to be vaccinated are surrounded by vaccinated people, they are more protected.  And school testing gives communities, schools, and families added reassurance that schools can open and remain open safely by swiftly identifying and isolating cases to effectively limit spread. 

We know what works.  Now let us unify together to follow these steps to ensure, fundamentally, that our children and our future are safe. 

Thank you.  I will now turn things over to Dr. Fauci.

DR. FAUCI:  Thank you very much, Dr. Walensky.  I would like to address my remarks today to COVID-19 vaccine efficacy and safety in adolescents. 

So, let’s first look at the efficacy of the mRNA vaccines in adolescents.  As you can see, these two New England Journal of Medicine papers — on the left, the one from BioNTech — Pfizer; and the one on the right, from Moderna.  Note that both of these have essentially a 100 percent vaccine efficacy against clinically recognizable disease, so these vaccines are highly efficacious in this population of adolescents.

Next slide.

If you look at where we stand now with regard to the Pfizer-BioNTech for adolescents, vis-à-vis authorizations and regulation — as you know, just to recall, the FDA issued an emergency use authorization for use in persons equal to or older than 16 years of age on December of 2020 — on the 11th. 

An EUA was expanded to include adolescents aged 12 to 15 years old on May 10th of this year, which was based on results from a phase three clinical trial.  And the vaccine was fully licensed by the FDA for persons aged equal to or older than 16 just in August 23rd of this year — just a few days ago.

The vaccine continues to be available, under an EUA, for younger individuals, namely adolescents 12 to 15 years of age.

Next slide.

So what about Moderna?  Moderna requested an EUA for their mRNA-1273 vaccine for adolescents 12 to 17 a couple of months ago — on June 10th of 2021 — and that FDA decision is pending.

What about safety?

Next slide.

Safety in these vaccines in adolescents — the expected mild, local, and systemic reactions, which are common among adolescents, similar very much to adults.  There are serious adverse events, but they indeed are rare.

Next slide.

These three MMWRs, which were reported from July 9th through August the 13th, addressed the issue of safety, particularly in the context of myocarditis.  And in every instance and every analysis, the risk-benefit ratio, given the risk of myocarditis and other aspects of disease with COVID-19 versus the risk of vaccination, in all determinations, the benefit has always very much outweighed the risk.

Last slide.

And so, what are the reasons for adolescents to be vaccinated against COVID-19?  First, we know the vaccines are safe, effective, convenient, and free.  The next is to obviously protect yourself from COVID-19, but also to help protect family members, friends, classmates, teachers, and other important people in the lives of the adolescent.  Some of them actually may be especially vulnerable to COVID-19 complications, and you might not know that they are vulnerable.  So, therefore, there’s so many, many reasons for adolescents to be vaccinated.

I’ll turn back to you now, Jeff.

MR. ZIENTS:  Thanks, Drs. Fauci and Walensky.  Let’s go ahead and open it up for a few questions. 


MODERATOR:  Thanks, Jeff.  First question, let’s go to Brenda Goodman at WebMD.

Q    Thank you.  Can you hear me?


MODERATOR:  It’s a little quiet, Brenda.

Q    Okay.  Dr. Walensky, I was glad to see that you wanted to talk about children.  And I haven’t seen the MMWR studies that you mentioned, but it sounded like those were conducted over the winter.  Is that correct?

DR. WALENSKY:  Um, actually, no.  One of them reaches out through June, and in fact, it’s the LA County — northern California one that speaks to the outbreak in the school.  And my understanding is that was with the Delta variant.

Q    Well, COVID cases in kids have increased fourfold in the past month.  The Children’s Hospital Association sent a letter to President Biden yesterday, saying that they are worried about running out events.  And you have repeatedly said schools can reopen safely if they follow the layered prevention strategies outlined by the CDC.

But yesterday in his podcast, Dr. Michael Osterholm said these guidelines have done a disservice to schools and parents.  He said they are largely based on studies done with previous and less transmissible versions of the virus and no longer apply under Delta.  He said, “Who in their right mind believes that an aerosol is only going to be transmitted three feet and that Plexiglas will make a difference?  That’s just wrong to continue to promote that, and the CDC guidelines do that, and less educators have become convinced that they can reopen their schools safely.  We have misled them.”

In light of the recent large increase in pediatric cases and the amount of transmission we’re already seeing in schools, do these guidelines need an update?  Do you stand by the idea that schools can be opened safely if they follow them?

DR. WALENSKY:  Thank you for that question, Brenda.  We have seen outbreaks in schools that are occurring now in the context of not following these layered prevention strategies.  These layered prevention strategies include not only vaccinating everyone who’s eligible for vaccination; not only masking, cohorting, ventilation strategies, screening strategies, hand hygiene — the whole layered mitigation.

And where we have seen these layer mitigations probably –properly employed, we have also seen that case — those cases really are reflective of what’s happening in high-community transmission.  But we have also seen that the cases are not propagated in the schools, and in fact, that schools tend to be safer places for our children than the communities in terms of COVID spread.

MR. ZIENTS:  Next question. 

MODERATOR:  Liz Szabo at Kaiser Health News. 

MR. ZIENTS:  I don’t think we’re hearing Liz. 

MODERATOR:  No.  All right, next question.  Let’s go to Tommy Christopher . 

Q    Oh, hi.  It’s Liz.

MODERATOR:  Hey, Liz.  Okay.

Q    Hi.  Sorry about that.  I had a question on the number of vaccinations.  Do we have any idea if these are first-time vaccinations, or if these are people coming in for — the worried well coming in for a third dose?

MR. ZIENTS:  The 1.1 million that was reported today — there were about a half million of people coming in for their first dose.  And as I said, that’s really important and part of a real acceleration of first doses that we’ve seen across the last several weeks, and very encouraging. 

Immunocompromised are eligible for a third dose and we’re seeing some increase there as planned.  But the vast majority of the doses are first doses and then people coming to complete their first dose three to four to five weeks later, per the plan. 

So, the vast majority of the doses are made up of first and second doses, but we are seeing some doses for those who are qualified for their third dose as they’re immunocompromised. 

Next question. 

MODERATOR:  All right, Tommy Christopher. 

Q    Hello, yes.  Thank you for the — for the briefing.  My question is sort of a one-and-a-half-part question, really.  The first half question being: I’m assuming that you still haven’t received any guidance from the Justice Department on whether or not the federal government has the authority to institute a national mask mandate, but you can correct me if I’m wrong about that. 

And so, my question is — for each one of you:  Just to be clear, if you had your druthers, would you prefer that every American be covered in some way by some sort of a vaccine mandate, be it local, state, employer, et cetera?

MR. ZIENTS:  So, we have no plans nor authority for a — I think what you called a “national mask mandate.” 

The President has taken significant action on vaccination requirements across the federal government, across the military, across health providers that it — that are at the Department of Health and Human Services and at the VA, and then also used the power of the government as payer, through CMS — which is Medicare and Medicaid — to require vaccinations for nursing home workers, in that the data is clear that when nursing home workers have a lower level of vaccination, that residents get infected and suffer the consequences of COVID at a higher rate. 

And the President will continue to look for every lever he can pull on vaccination requirements.  And we’re all very heartened by the fact that private-sector, public-sector schools are following suit with vaccination requirements.

Next question.

MODERATOR:  All right.  And a reminder: Keep your question to one question. 

Dan Vergano, BuzzFeed.

Q    Thanks very much.  Dan Vergano, BuzzFeed.  For Dr. Walensky or Dr. Fauci: We’re wondering if you have a view on hospitalization rate among children diagnosed with COVID-19.  We’re relying on AAP suggesting it’s about a 1 percent rate for, you know, children diagnosed with COVID-19 resulting in hospitalization, but some hospitals are telling us they’re seeing much higher rates like around 15 percent.  And so, I’m wondering if you could offer some perspective on what you see as the rate.  Thanks very much.

MR. ZIENTS:  Dr. Walensky. 

DR. WALENSKY:  Sure.  You know, what we’re seeing here is increase in cases across the country, and, therefore, increase in cases in hospitalizations of all age demographics.  They tend to be consistent in terms of across the age demographics, meaning that the rates of hospitalization are actually higher among older-age demographics than they are in the pediatric-age demographic. 

But the — because the absolute number of cases is so high — the absolute number of children who are coming into the hospital is so high — is high — it’s also the case that we are currently within a surge of RSV cases as well — respiratory syncytial virus cases.  Many of the hospitalizations that are accumulating in pediatric hospital beds are infected with RSV.  We’re seeing RSV rates similar to what we had seen — what we generally see in the winter months. 

So that is actually also contributing to the hospital bed cr- — pediatric hospital bed crunch.

MR. ZIENTS:  Next question.

MODERATOR:  Last question.  Let’s go to Josh Wingrove at Bloomberg.

Q    Hi.  So are you — just to follow up on a couple of them: Are you reviewing the school guidance in light of Delta?  Will it be updated, or is the guidance, as it exists now, the guidance that will exist for the school year, or at least the start of it?

And is the hospitalization rate higher than what we understand it to be?  Do you have data on that?  You said it’s rising just because all cases are rising, but do you have numbers on that?

DR. WALENSKY:  We are not looking at updating our school guidance right now.  I can tell you that most of the places where we’re seeing surges and outbreaks are in places that are not implementing our current guidance. 

The hospitalization rates that we’re seeing with children right now are similar to prior surges.  It’s the absolute number of cases that we’re seeing those increase in.

MR. ZIENTS:  Well, thank you, everybody.  We’ll look forward to returning to our normal format next week.  And I hope everybody has a good weekend. 

Thank you.

11:28 A.M. EDT

To view the COVID Press Briefing slides, visit:

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